The goal of the proposed research is to determine optimum care for children with all types of cancer. The research mechanism involves participation in collaborative multidisciplinry clinical cancer research protocols generated through the Southwest Oncology Group. The proposed research grant will allow the continued participation of the Divisions of Pediatric Hematology-Oncology, Pediatric Surgery, Therapeutic Radiology, and the Departments of Pathology, and Microbiology and Immunology at Duke University Medical Center in Southwest Oncology Group activities. These activities involve studies of the natural history, immunology, and multimodal therapy of all childhood malignancies. Cooperative studies among physicians from a group of medical centers allows for rapid accrual of a statistically significant number of children with cancer in order to quickly define those avenues of therapy which provide prolonged survival. Through participation in cooperative studies, the entire medical community engaged in the care of children with cancer has a focal point to provide not only improved patient care, but also improved multidisciplinary teaching and research. Our objectives for the coming years are: 1) to develop additional protocols for the immunologic diagnosis and management of patients with malignant lymphoproliferative disorders, 2) to continue our multidisciplinary research efforts in other cancers of children, and 3) to expand our outreach programs for education and patient care to satellite institutions and physicians in the regions.